The Effect of Curcumin (as Meriva) on Absolute Lymphocyte Count (ALC), NK Cells and T Cell Populations in Patients with Stage 0/1 Chronic Lymphocytic Leukemia

Purpose: To determine the effect of curcumin (as Meriva) on absolute lymphocyte count (ALC), T cell populations and NK cells in patients with Rai stage 0/1 chronic lymphocytic leukemia (CLL) over a period of six months. Experimental Design: Twenty-one patients with significant lymphocytosis (>20 × 109 lymphocytes/L) and stage 0/1 CLL were recruited into the study and received oral curcumin 2 grams/day. Blood samples were collected at baseline and at 2 monthly intervals for six months for full blood count, leukocyte surface antigens, liver function, serum biochemistry, immunoglobulins, CRP and ESR. A positive biologic response was defined as a reduction in the ALC of more than 20% from pre-treatment levels. Results: Four patients (20%) demonstrated more than 20% decrease in ALC, three of whom had lower ALC at the end of the study as compared to baseline. The decrease in ALC was accompanied by an increase in CD4, CD8 and NK cells. No demonstrable response was seen in seventeen patients (80%) who exhibited stable, fluctuating or increasing ALC during the study. Conclusion: A subgroup of stage 0/1 CLL patients may be responsive to curcumin therapy. The beneficial response appears to be immunomodulated.

Comparative Rates of Adverse Events with 2-Hour versus 4-Hour Infusion of Total Dose Intravenous Iron Polymaltose

Background and aim of the study: Patients with iron deficiency (ID) who are unable to tolerate or show sub-optimal response to oral iron therapy are candidates for parenteral iron therapy. This study evaluated the patient safety and tolerance of iron polymaltose given either as a 2-hour infusion or as a 4-hour infusion. Methods: A total of 243 patients with ID were randomized alternatively to receive iron polymaltose infusion either as a 2-hour infusion or as a 4-hour infusion. All patients received pre-medication with certizine hydrochloride 10 mg PO one-hour before infusion and hydrocortisone 50 mg IVI immediately before infusion. Infusion related adverse events/side-effects during the infusion and over the next seven days were documented and graded as mild, moderate or severe. Results: The age of the patients ranged from 17 years to 92 years (mean 55.5 yr);M:F = 1:3.5. One hundred and twenty-two patients were in the 2-hour arm (M:F = 1:5;mean age 52.9 yr) and 121 were in the 4-hour arm (M:F = 1:2.6;mean age 58.1 yr). Iron infusion therapy was generally well tolerated by patients in both arms. Adverse events/side effects were documented in 14 patients in each arm (22 events in the 2-hour arm and 20 in the 4-hour arm) and included aches and pains, cannula-site pain/swelling, nausea, abdominal cramps, rash, vagal response, metallic taste, hot flushes and headaches. In most patients, these events were mild and none had any severe events. Conclusion: The incidence of adverse events with 2-hour infusion of iron polymaltose is similar to that observed with 4-hour infusion of iron polymaltose.

Dasatinib-Induced Hepatic Dysfunction

A 53-year-old man with chronic myeloid leukaemia developed significant hepatic dysfunction when treatment was changed from imatinib (because of drug-induced rash) to dasatinib. Liver function tests returned to normal 77 days after cessation of therapy and have remained normal despite recommencement of dasatinib. Although the pathogenesis for the significant hepatic dysfunction is unclear, this case illustrates the reversibility of this event with dose interruption and that dasatinib can be safely recommenced for ongoing treatment.